Flexion and internal rotation, abduction, adduction and external rotation (add/ER limitation = little to none)
Capsular pattern: Tibiofemoral
Flexion (++), extension (minor)
Capsular pattern: Tibiofibular
Pain when stressed
Capsular pattern: Talocrural
Plantarflexion, dorsiflexion
Capsular pattern: Subtalar
Increasing limitation of varus. When fixed in valgus: Inversion, eversion
Capsular pattern: Midtarsal
Supination, pronation (with limited DF, PF, Add and IR)
Capsular pattern: 1st Metatarsophalangeal
Extension (++), flexion (minor)
Capsular pattern: Metatarsophalangeal 2-5
Variable, usually flexion restriction
Capsular pattern: Interphalangeal (foot)
Usually extension restriction
Angles of head of humerus
20-30 degrees retroversion Longitudinal axis of head is 135 degrees from axis of neck
Scapula position
2nd to 7th ribs
Glenoid fossa position and shape
At lateral angle Pear-shaped Faces anteriorly, laterally and superiorly Places true abduction at 30 degrees anterior to frontal plane
Corocohumeral ligament: Attachments and function
Base of coracoid to greater and lesser tubercles of the humerus. Reinforces biceps tendon and superior capsule Prevents caudal dislocation (Taut with external rotation)
Glenoid labrum attachments
Superior and inferior capsule, long head of biceps attachment
Scapulothoracic & Glenohumeral rhythm
At 75 degrees shoulder flexion, humerus external rotates to prevent compression of greaster tuberosity on acromion.
180 degrees abduction: 2:1 movement ratio 1st 30-60 degrees at GHJ 120 degrees of total movement occurs at GHJ 60 degrees of total movement occurs at scapulothoracic joint
Joint movements during shoulder flexion
Humerus glides inferiorly and external rotates Clavical rotates at sternoclavicular joint Scapula abducts and laterally rotates
Elbow 'Screw home' mechanism
Ulna pronates slightly with extension and supinates slightly with flexion Proximal ulna glides medially during extension and laterally during flexion
Radiocarpal joint articulations
Lunate and scaphoid with radius Triquetrum with ulna
Volar Plate
Thickening of capsule on palmar aspect of MCP, PIP and DIP joints. More mobile at MCPs than IPs.
Finger ligs: Collateral
From lateral condyle to distal phalanx and lateral volar plate. Tighten with flexion. Volar fibers also tighten with extension.
Finger ligs: Accessory
From condylar head to volar plate
Finger ligs: Transverse
Link MCPs Reinforce anterior capsule
Digit rotation during flexion/extension
Phalanges and metacarpals rotate radially during flexion
1st CMC movement
Rotated position of trapezium places plane of flexion/extension of 1st CMC perpendicular to other digits.
Posterior knee (often connected to synovial cavity)
Bursae Locations: Semimembranosus
Between semimembranosus and femoral condyle
Bursae Locations: Gastrocnemius
One under each head
Bursae Locations: Pes anserine bursa
Between pes anserinus and MCL
Bursae Locations: Subtendinous iliac
Between hip and os pubis
Bursae Locations: Iliopectineal
Between tendon of illiopsoas and capsule (close to femoral nerve)
Bursae Locations: Ischiofemoral
Between ischial tuberosity and gluteus maximus
Bursae Locations: Deep trochanteric
Between gluteaus maximus and posterior lateral greater trochanter (may cause pain on hip flexion and internal rotation due to compression of gluteus maximus)
Bursae Locations: Superficial trochanteric
Over greater trochanter
Bursae Locations: Subacromial
Under deltoid, extending under acromion and coracoacromial arch above the joint capsule
Bursae Locations: Olecranon
Posterior aspect of elbow over olecranon process
Knee 'screw home' mechanism
At terminal extension the tibia externally rotates 5 degrees due to:
Lateral femoral condyle has a longer articular surface than medial (20 deg femoral roll laterally; 10-15 deg medially) Medial meniscus attached to MCL which restricts medial gliding Twisted cruciate ligaments Lateral pull of quads
Talocrural osteokinematics
Open Chain Plantarflexion: Talus glides anteriorly on mortise and medially rotates slightly. (opposite for DF)
Closed Chain Plantarflexion: Tibia glides posteriorly on talus and laterally roates slightly. (opposite for DF)
Subtalar osteokinematics
Open Chain Inversion: Calcaneus adducts, supinates and plantarflexes on fixed talus. (opposite for eversion)
Closed Chain Inversion: Talus glides laterally, abducts and dorsiflexes. Produces external rotation of tibia. (opposite for eversion).
Talonavicular osteokinematics
Open Chain Inversion: Navicular plantarflexes, adducts and externally rotates on the talus. (opposite for eversion).
Closed Chain Inversion: Talus glides dorsally, abducts and internally rotates on navicular. (opposite for eversion)
Thoracic Spine "Rule of 3"
T1-T3 spinous processes even with transverse processes T4-T6 spinous processes found 1/2 level below transverse processes T7-T9 spinous processes at level of transverse process of vertebra below T10 at level of vertebra below T11 1/2 level below T12 level with it's own transverse processes
Cervical Spine Coupled Movement Direction (rotation/side flexion)
Occiput/C1: Opposite C2-C7: Same Lumbar/Thoracic (in Neutral or extension): Opposite Lumbar/Thoracic (in flexion): Same (differs among individuals, should be tested prior to any manual technique)
Neuro/Musculo screen (muscles supplied by peripheral nerves): Accessory obturator
(Usually absent) Pectineus
Neuro/Musculo screen (muscles supplied by peripheral nerves): Tibial
(posterior leg and thigh) Temitendinosus, semitmembranosus, long head of biceps femoris, adductor magnus, gactocnemius, soleus, plantaris, popliteus, FDL, FHL, tibialis posterior
Neuro/Musculo screen (muscles supplied by peripheral nerves): Medial plantar
(from tibial nerve - supplies medial sole of the foot) FHB, AbH, FDB, 1st lumbricle
Neuro/Musculo screen (muscles supplied by peripheral nerves): Lateral plantar
(from tibial nerve - supplies lateral sole of foot) Quadratus plantae, lateral 4 lumbricles, AdH, FDM, AbDM, interossei
Neuro/Musculo screen (muscles supplied by peripheral nerves): Femoral
Special Tests (structure being tested & procedure): Neer impingement
Long head of biceps and supraspinatus impingement Passive internal rotation followed by full passive abduction
Special Tests (structure being tested & procedure): Empty can
Tear/impingement of supraspinatus or suprascapular nerve pathology Shoulder at 90 deg abduction, no rotation, resist abduction Horizontally adducted shoulder 30 deg, full IR, resist abduction
Special Tests (structure being tested & procedure): Drop arm test
Tear/rupture of rotator cuff Passive shoulder abduction 120 deg Patient slowly lowers arm to side (guard incase arm gives way) +ve if patient unable to slowly to lower to side
Special Tests (structure being tested & procedure): Posterior internal impingement
Impingment of rotator cuff on greater tuberosity or posterior labrum Supine, passive 90 deg abd, max ER, 15-20 deg horizonal add
Special Tests (structure being tested & procedure): Clunk test
Glenoid labrum tear Supine, full abduction PA humeral head with ER
Special Tests (structure being tested & procedure): Posterior apprehension sign
Supine, shoulder abducted 90 deg in scapular plane AP through elbow with IR and horizontal add
Special Tests (structure being tested & procedure): AC shear test
SC joint dysfunction (arthritis, seperation etc) Sitting, arm at side PT clasps hands with heel of one hand on spine of scapula, other on clavicle Squeeze hands to compress AC
Special Tests (structure being tested & procedure): Adson's
Thoracic outlet syndrome Sitting, find radial pulse Neck rotation towards test side Shoulder extension and ER with neck extension (looking for neurological/vascular signs)
Special Tests (structure being tested & procedure): Costoclavicular syndrome (Military brace) test
Thoracic outlet syndrome Sitting, find radial pulse Move test shoulder back and down (Looking for neurological/vascular signs)
Special Tests (structure being tested & procedure): Wright (hyperabduction) test
Thoracic outlet syndrome Sitting, find radial pulse Passive shoulder abduction and ER Deep breath with contralateral neck rotation may increase symptoms (Looking for neurological/vascular signs)
Special Tests (structure being tested & procedure): Roos elevated arm test
Thoracic outlet Standing, shoulders abducted 90 deg, full ER, slight horizontal abduction, 90 deg elbow flexion Patient opens and closes hands slowly for 3 minutes (Looking for neurological/vascular signs)
Special Tests (structure being tested & procedure): Elbow ligament instability
Varus/valgus forces with elbow in 20-30 deg flexion
Special Tests (structure being tested & procedure): Lateral epicondylitis
90 degrees elbow flexion Resist wrist extension, pronation and radial deviation with hand in fist
Cozen's test - as above with elbow in slight flexion and palpation of lateral epicondyle
Special Tests (structure being tested & procedure): Medial epicondylitis
90 degrees elbow flexion Passive supination, elbow and wrist extension
Special Tests (structure being tested & procedure): Pronator teres syndrome test
Median nerve entrapment within pronator teres Sitting, elbow flexed to 90 degrees Resist pronation and elbow extension (looking for tingling/paresthesia in median nerve distribution)
Special Tests (structure being tested & procedure): Finkelstein
deQuervain's tensynovitis (AbPL, EPB) Fist with thumb inside Passive ulnar deviation
Special Tests (structure being tested & procedure): Bunnel-Littler
Tightness in structures around MCP joints MCP held in slight extension, PIP flexed MCP and PIP flexed If flexion limited in both tests, capsule is tight If flexing MCP increases PIP ROM, intrinsic muscles are tight
Special Tests (structure being tested & procedure): Tight retinacular test
Tightness around PIP joint (hand) PIP stabilized while DIP flexed PIP and DIP flexed If flexion limited in both tests, capsule is tight If flexing PIP increases DIP ROM, instrinsic muscles are tight
Special Tests (structure being tested & procedure): Froment's sign
Ulnar nerve dysfunction Patients grasps paper between 1st and 2nd digits Pull paper out Look for IP flexion of thumb (compensation for weak AddPL) May indicate ulnar nerve dysfunction
Special Tests (structure being tested & procedure): 2 point discrimintion test (hand)
Use paper clip/calipers etc to stimulate 2 points on palmar aspect of fingers Record smallest distance patient is able to distinguish Should be <6 mm
Special Tests (structure being tested & procedure): Allen test
Vascular compromise Patient opens and closes their hand several times, then makes a fist Oclude ulnar artery, then have patient open their hand Observe palm, release and wait for filling Repeat with radial artery
Special Tests (structure being tested & procedure): ULTT1
Median Nerve, anterior interosseous nerve, C5-7 Shoulder depression and 110 degrees abduction Elbow extension Forearm supination Wrist extension Finger/thumb extension Contralateral neck side flexion
Special Tests (structure being tested & procedure): ULTT2
Median, musculocutaneous Shoulder depression and 10 degrees abduction Elbow extension Forearm supination Wrist extension Finger/thumb extension Shoulder ER Contralateral neck side flexion
Special Tests (structure being tested & procedure): ULTT3
Radial Shoulder depression and 10 degrees abduction Elbow extension Forearm pronation Wrist flexion and ulnar deviation Finger/thumb flexion Shoulder IR Contralateral neck side flexion
Special Tests (structure being tested & procedure): ULTT4
Ulnar nerve, C8-T1 Shoulder depression and 90 degrees abduction (hand to ear) Elbow flexion Forearm supination Wrist extension and radial deviation Finger/thumb extension Shoulder ER Contralateral neck side flexion
Special Tests (structure being tested & procedure): Patrick (FABER) test
Hip dysfunction (e.g. mobility restriction), iliopsoas dysfunction, SIJ dysfunction Supine Passive flexion, abduction, ER - foot resting just above opposite knee Slowly lower testing leg to surface (look for knee unable to assume relaxed position or for symptom reproduction)
Special Tests (structure being tested & procedure): Grind (Scouring) test
(aka quadrant) Degenerative joint disease, AVN, osteochondral defect Hip and knee flexion, hip adduction with pressure through joint
+ve = grinding, catching, crepitation
Special Tests (structure being tested & procedure): Ober's
ITB/TFL tightness Side-lying, lower hip and knee flexed Passively extend test hip with knee flexed to 90 degrees Slowly lower to table (should come to rest on table)
Special Tests (structure being tested & procedure): Ely test
Rectus Femoris tightness Prone Flex testing knee (look for ipsilateral hip flexion)
Special Tests (structure being tested & procedure): 90-90 hamstring test
Hamstring tightness Supine, hip and knee supported in 90 degrees flexion Passively extend knee as far as possible (positive if unable to reach 10 degress from full extension)
Special Tests (structure being tested & procedure): Piriformis test
Supine, test foot placed on opposite knee Testing hip adducted (positive if testing knee unable to pass over resting knee or if symptoms reproduced)
Special Tests (structure being tested & procedure): Craig's test
Abnormal femoral anteversion angle Prone, knee flexed to 90 degrees Palpate greater trochanter, move hip through IR/ER When greater trochanter feels most lateral, measure angle of leg relative to perpendicular (norm= 8-15 degrees; <8 = retroverted; >15=anteverted)
Special Tests (structure being tested & procedure): Knee collateral ligament instability
Valgus/varus force in 20-30 degrees knee flexion
Special Tests (structure being tested & procedure): Lachman
Special Tests (structure being tested & procedure): Pivot Shift
(Anterolateral rotary instability of the knee - ACL) Supine, test knee extended, hip flexed and abducted 30 degrees, slight IR
PT grasps leg with one hand and places other over lateral surface of proximal tibia IR, valgus force through knee with flexion
positive = palpable shift of clunk occurring between 30-40 degrees of flexion (ITB relocates tibia Indicates anterolateral instability
Special Tests (structure being tested & procedure): Posterior sag
PCL Supine, testing hip flexed to 45 degrees, knee flexed to 90 (look for tibia saggin posteriorly relative to femur)
Special Tests (structure being tested & procedure): Reverse Lachman
PCL Prone, knee flexed to 30 Stabilize femur, glide tibia posteriorly
Special Tests (structure being tested & procedure): Apley
Differentiate between meniscal and ligamentous lesions Prone, test knee flexed to 90 degrees Stabilize thigh with knee Passively distract knee joint, slowly rotates tibia internally and externally (Pain or decreased motion during compression= meniscal) Pain or decreased motion during distraction = ligamentous)
Special Tests (structure being tested & procedure): Hughston's plica test
Supine, test knee flexed, tibia internally rotated Glide patella medially while palpating medial femoral condyle Passively flex and extend knee (look for pain and/or popping)
Special Tests (structure being tested & procedure): Clarke's sign
Patellofemoral dysfunction Supine, knee extended, AP at patella superior pole Patient contracts quads (positive if painful)
Special Tests (structure being tested & procedure): Ballotable patella
(Patellar tap) Infrapatellar effusion Soft tap over central patella (positive if patella "floats")
Special Tests (structure being tested & procedure): Fluctuation test
Knee joint effusion Supine, knee extended Push down over suprapatellar pouch Push down over anterior aspect of knee joint Alternate movements looking fluid movement
Special Tests (structure being tested & procedure): Q-angle
Angle between quads muscle and patellar tendon (Norms: M=13 deg; F=18 deg)
Special Tests (structure being tested & procedure): Noble compression test
Distal ITB friction syndrome Supine, hip flexed to 45 degrees, knee flexed to 90 Apply pressure to lateral femoral epicondyle, extend knee (positive if pain reproduced over lateral epicondyle - should be at ~ 30 deg flexion)
Special Tests (structure being tested & procedure): Neutral subtalar positioning
Check for abnormal forefoot/rearfoot positioning Prone, foot over edge of plinth Palpate dorsal talus on both sides with one hand, lateral forefoot with other hand DF until resistance is felt, move through supination/pronation Neutral=point at which foot falls off easier to one side or the other At neutral compare rearfoot to forefoot
Special Tests (structure being tested & procedure): Anterior drawer
Ligament instability (particularly ATFL) Supine, heel off bed, 20 degrees PF Stabilize lower leg, grasp foot Pull talus anteriorly (positive if excessive movement and/or pain)
Special Tests (structure being tested & procedure): Talar tilt
Special Tests (structure being tested & procedure): Thompson test
Achilles tendon integrity Prone, foot off edge if plinth Squeeze calf (no movement = rupture)
Special Tests (structure being tested & procedure): Tinel's sign
Tap nerve to identify dysfunction: - Posterior tibial nerve: posterior to medial maleolus - Deep peroneal nerve: anterior to talocrural joint - Median nerve: anterior wrist - Ulnar nerve: cubital tunnel
(positive if pain/tingling/paresthesia produced in respective nerve distributions)
Special Tests (structure being tested & procedure): Morton's test
Identifies stress fractures and neuromas in forefoot Supine Grab around met heads and squeeze (Positive if pain in forefoot)
Special Tests (structure being tested & procedure): VBI test
Assesses integrity of vertebrobasilar vascular system Supine, head supported Progress through following procedures if no symptoms produced after each step 1) Extend head and neck for 30 seconds 2) Extend head and neck with left then right rotation for 30 seconds 3) Cradle head off the table and extend head and neck for 30 seconds 4) Cradle head off the table and extend head and neck with rotation left then right for 30 seconds (positive if dizziness, visual disturbances, disorientation, blurred speech, nausea or vomiting occur) (MOBS/MANIPS AT CxSp WITHOUT TESTING VBI FIRST IS A BREACH OF CARE)
Special Tests (structure being tested & procedure): Hautant's test
Differentiates vascular versus vestibular causes of dizziness/vertigo 1) Patient sits with shoulders at 90 deg and palms up Close eyes, sit still for 30 seconds. (If arms loose their position there may be a vestibular condition) 2) Patient sits with shoulders at 90 deg and palms up Close eyes, extend head and neck with rotation right then left remaining in each position for 30 seconds (If arms loose their position there may be a vascular condition)
Special Tests (structure being tested & procedure): Transverse ligament stress test
Tests integrity of the transverse ligament Supine C1 PA (should be firm end-feel) (Positive if end-feel is soft, dizziness, nystagmus, lump in throat, nausea etc.)
Special Tests (structure being tested & procedure): Anterior shear test
Assesses integrity of upper CxSp ligaments/capsules Supine PA C2-C7 (should be firm end-feel) (Positive if end-feel is soft, dizziness, nystagmus, lump in throat, nausea etc.)
Special Tests (structure being tested & procedure): Foraminal compression (Spurling's test)
Dysfunction (usually compression) of CxSp nerve root Sitting with head sidebent towards uninvolved side Apply pressure straight down through the head Repeat with sidebend the other way (Positive if pain and/or paresthesia in dermatomal pattern for involved nerve root)
Special Tests (structure being tested & procedure): Maximum cervical compression test
Compression of neural structures at IV foramen and/or facet dysfunction Sitting Passively sidebend and rotate head towards non-painful side followed by extension Repeat towards painful side (BE CAREFUL-VERY SIMILAR TO VBI TEST) (Positive if pain/paresthesia (nerve root) or localized neck pain (facet dysfunction)
Special Tests (structure being tested & procedure): Distraction test
Indicates compression of neural structures at IV foramen or facet dysfunction Sitting, head passively distracted (Positive if symptoms decrease (facet) or there is a decrease in upper limb pain (neurological)
Special Tests (structure being tested & procedure): Shoulder abduction test
Indicates compression of neural structures within IV foramen Sitting, patient places one hand on their head, repeat with other hand (positive if upper limb symptoms decrease)
Special Tests (structure being tested & procedure): Lhermitte's sign
Dysfunction of spinal cord and/or UMNL Long sitting Passively flex head and one hip while keeping knee extended Repeat with other hip (Positive if pain down the spine and into limbs)
Special Tests (structure being tested & procedure): Romburg's test
UMNL Standing, close eyes for 30 seconds (Positive if excessive swaying)
Special Tests (structure being tested & procedure): Rib Springing
Evaluates rib mobility Prone PA ribs beginning at upper ribs Repeat in sidelying (BE CAREFUL WITH RIBS 11 & 12 - NO ANT. ATTACHMENT = LESS STABLE) (positive if motions is increased or restricted
Special Tests (structure being tested & procedure): Thoracic springing
IV joint mobility in thoracic spine Prone PA glides/springs to thoracic TPs (Positive if pain, increased/decreased movement)
Special Tests (structure being tested & procedure): Slump test
Dysfunction of neurological structures supplying LL Sitting on edge of plinth, knees flexed Slump while maintaining neutral head and neck Progress through following steps if no symptoms: 1) Passive head and neck flexion 2) Passive knee extension 3) Passive DF of extended leg 4) Repeat with other leg (positive if near symptoms reproduced)
Special Tests (structure being tested & procedure): Lasegue's (SLR)
Dysfunction of neurological structures supplying LL Supine Passively flex hip with knee extended until shooting pain occurs Slowly lowers until pain subsides, DF foot (Positive if near symptoms reproduced when foot is DF)
Special Tests (structure being tested & procedure): Femoral nerve traction test
Compression of femoral nerve Lie on non-painful side, trunk neutral, slight head flexion, lower-limb hip and knee flexed Passively extend hip while knee of painful limb is in extension If no symptoms, flex knee of painful leg (Positive if neuro pain in anterior thigh)
Special Tests (structure being tested & procedure): Valsalva maneuver
Space occupying lesion Sitting Patient takes deep breath and holds it while "baring down" (as though having a bowel movement) (Positive if LBP increases or near symptoms into LLs)
Special Tests (structure being tested & procedure): Babinski
UMNL Supine or sitting Glide bottom of reflex hammer along plantar surface of foot (Positive if big toe extend and others abduct or "splay")
Special Tests (structure being tested & procedure): Quadrant
Compression of neural structures at IV foramen and facet dysfunction Standing: 1) IV foramen: Side bend left, rotation left, extension. Repeat to right. 2) Facet: Side bend left, rotation right, extension. Repeat to right.
(Positive if pain/paresthesia (IV foramen) or localized pain (facet).
Special Tests (structure being tested & procedure): Stork standing test
Spondylolisthesis Stand on one leg Extend trunk Repeat with other leg (Positive if pain in lower back with ipsilateral leg on the ground)
Special Tests (structure being tested & procedure): McKenzie side glide test
Differentiates between scoliotic curve and near dysfunction causing lateral shift (Performed if lateral shift is noted) Standing with PT on side of patient that spine is shifted towards PT places their shoulders into patient's upper trunk and wraps arms around pelvis Stabilize upper trunk, pull pelvis to bring into alignment (Positive if neuro symptoms reproduced as alignment is corrected)
Special Tests (structure being tested & procedure): Bicycle (van Gelderen test)
Differentiates between intermittent claudication and spinal stenosis Rides stationary bike with trunk erect Time how long they can ride at set pace/speed After sufficient rest ride again in slumped position (If pain is related to stenosis patient should be able to ride longer while slumped)
Special Tests (structure being tested & procedure): Gillet's test
Assess movement of ilium relative to sacrum Standing PT thumb under PSIS of limb to be tested, other thumb on center of sacrum at same level as thumb under PSIS Patient flexes hip and knee of test limb Assess movement by comparing thumb position (PSIS should move inferiorly) (Positive if no movement of PSIS relative to sacrum)
Special Tests (structure being tested & procedure): Ipsilateral anterior rotation test
Assess anterior movement of ilium relative to sacrum PT thumb under PSIS of limb to be tested, other thumb at center of sacrum at the same level and other thumb Patient extends hip of test limb Assess PSIS movement (PSIS should move superiorly) (Positive if no movement as compared to sacrum)
Special Tests (structure being tested & procedure): Gaenslen's test
SIJ dysfunction Sidelying at edge of table, holding bottom leg maximal hip and knee flexion PT standing behind patient, passively extend hip of top limb (stresses ipsilateral SIJ) (Positive if pain at SIJ)
Special Tests (structure being tested & procedure): Long sitting (supine to sit) test
SIJ dysfunction which may be the cause of leg length discrepancy Supine in good alignment PT at end of plinth, palpate medial maleoli, check symmetry Patient moves to long sitting, reassess at maleoli (Positive if limb lengths reverse from supine to long-sit)
Special Tests (structure being tested & procedure): Goldthwait's test
Differentiates between LxSp and SIJ dysfunction Supine, PT fingers between SPs of LxSp With other hand perform SLR (If pain presents prior to palpation of movement at LxSp, dysfunction is related to SIJ)
Special Tests (structure being tested & procedure): TMJ compression
Compression of retrodiscal tissues Sitting or supine Stabilize head with one hand, with other push mandible superior causing compressing to TMJ (Positive if pain reproduced)
Special Tests (structure being tested & procedure): Ludington's test
Assess for long head of biceps rupture
Sitting Hands behind head, fingers interlocked Pt alternately contracts and relaxes biceps muscles Absense of movement = rupture
Special Tests (structure being tested & procedure): Allen test (thoracic outlet)
Sitting/standing Test arm in 90 degrees abduction, ER, elbow flexion
Pt rotates head away from test shoulder while PT monitors radial pulse
+ve = diminshed/absent pulse
Special Tests (structure being tested & procedure): Mill's test
Lateral epicondylitis test
Pt sitting PT palpates lateral epicondyle
Passive pronation, wrist flexion, elbow extension
Special Tests (structure being tested & procedure): Capillary refill test
Pt sitting/standing
PT compresses nailbed and after releasing the pressure notes the amount of time taken for the color to return to the nail.
+ve = delayed/muted response (greater than 2 seconds) May indicate arterial insufficiency
Special Tests (structure being tested & procedure): Grind test (hand)
Pt sitting/standing
PT stabilize pt's hand, grasp thumb on metacarpal Apply compression and rotation through met.
+ve = pain - indicates DJD at MCP joint
Special Tests (structure being tested & procedure): Piriformis test (from scorebuilder's)
Pt sidelying test leg up, hip flexed to 60 degrees
PT places one hand on pelvis, other on knee While stabilizing pelvis, push (adduction force) down on knee
+ve = pain/tightness - may indicate piriformis tightness or sciatic nerve compression by piriformis
Special Tests (structure being tested & procedure): Tripod sign
Pt sitting with knees flexed to 90 degrees off edge of table
PT passively extends one knee
+ve = tightness in hamstring or trunk extension to limit efect of tight hamstring
Special Tests (structure being tested & procedure): Barlow's test
Test for hip dysplasia
Pt supine, hips flexed to 90, knees flexed
PT tests each hip individually by stabilizing femur and pelvis with one hand while other hand moves test leg into abduction while applying fwd pressure on greater trochanter
Click/clunk may indicate hip dislocation being reduced
Special Tests (structure being tested & procedure): Ortolani's test
Test for hip dysplasia
Pt supine, hips flexed to 90, knees flexed
PT grasps legs so thumbs are along pt's medial thighs and fingers are on lateral thighs towards buttocks. PT abducts hips and gentle pressure is applied to greater trochs until resistance is felt at ~30 degrees.
+ve = click/clunk, may indicate reduction of a dislocation
Special Tests (structure being tested & procedure): Slocum's test
Pt supine, knee flexed to 90 degrees, hip flexed to 45
PT rotates pt's foot 30 IR (to test anterolateral instability) PT rotates pt's foot 15 ER (to test anteromedial instability) PT stabilizes lower leg by sitting on forefoot Grasp prox tibia with two hands, thumbs on tibial plateau, PA to tibia on femur
+ve = movement of tibia occurring primarily on lateral side = may indicate anterolateral instability
Special Tests (structure being tested & procedure): Bounce home test